WWYD: Induction?

[emeraldjoy]

Hello. Thank you so much for reading this.

 

So I am a bit more than 38 weeks preggers and I had one of those infamous pelvic checks yesterday.

According to the OB, I am "ripe" (What a wierd word...still trying to get over it) and a few cm dialated AND....he said the baby is already 8 pounds AND if I go full term he/she could possibly be 10 lbs!! The OB then offered an induction for next week when I am more than 39 weeks. He said it is comletely up to me, but I an ready (physically) and he is more than willing to schedule one to keep the weight of the baby down.

 

Now.... a bit of history.

 

This is my 4th child; first 2 not induced but water was broken. 3rd was induced and was my most painful labour and delivery (even though he was out in 2 pushes) and I was terrified of C-section the whole time, very anxious.

 

My second child was 9 1/2 lbsand needless to say IT HURT and he got stuck and came out with an almost broken clavical and bruised face and head.

 

Right now I am trying to weigh the risk; induction vs. huge baby....and I really don't know what to do. This whole pregnency I kept on saying I will never be induced again....but this was before I thought I was having such a huge baby.

 

How often are they wrong in guessing the weight?

 

thank so much for your time and thoughts on this.

 

emerald

[mellifera]

I was induced 4 times. It was kind of nice to be able to schedule when the baby came. For me it was the right thing to do. If you are "ripe" your doctor might just break your water and your body would do the rest.

[Quiver0f10]

They are wrong a lot on the weight and it's all just a guessing game. I personally wouldn't get induced unless some true medical reason came up. You have birthed a 9# baby before so you should be fine. There are different positions you can push in to help open up the birth canal and on your back is the worst to be in. It will all be over soon and you will be holding that precious bundle!

 

 

I am a big believer in letting nature takes it's course.

[Jami]

Nope, I wouldn't do it.

 

Estimating size is notoriously inaccurate as is how ready a body to go into labor IMHO.

 

I was induced with my 2nd and 3rd. The 3rd ended in a c-section, one that I think could have been avoided if I'd waited on my body to tell me everything was ready to go.

 

Even being 38 weeks can be off, babies don't develop at the same rate. I've heard of moms being told they were 38 weeks, or even 40 weeks and the baby is 36 weeks in development. Then you risk weak lungs and other complications.

 

I chose a very hands-off midwife this time around because I KNOW at 38 weeks (and likely at 40 weeks) I'd be begging a willing doc to induce. Cause that's how you feel at the end! But I don't even want the option available to me this time, I know in my head it's better for a good labor and healthy baby to wait it out.

 

And plenty of women have 9, 10, and 11 lb babies (Did you HEAR OhElizabeth's story!) just fine around here from what I've seen. I've not passed the 8.5 lb mark yet, but from the wonderful stories I've heard on this board, I don't fear a larger baby the way I might otherwise have. :001_smile:

[Quiver0f10]

Nope, I wouldn't do it.

 

Estimating size is notoriously inaccurate as is how ready a body to go into labor IMHO.

 

I was induced with my 2nd and 3rd. The 3rd ended in a c-section, one that I think could have been avoided if I'd waited on my body to tell me everything was ready to go.

 

Even being 38 weeks can be off, babies don't develop at the same rate. I've heard of moms being told they were 38 weeks, or even 40 weeks and the baby is 36 weeks in development. Then you risk weak lungs and other complications.

 

I chose a very hands-off midwife this time around because I KNOW at 38 weeks (and likely at 40 weeks) I'd be begging a willing doc to induce. Cause that's how you feel at the end! But I don't even want the option available to me this time, I know in my head it's better for a good labor and healthy baby to wait it out.

 

And plenty of women have 9, 10, and 11 lb babies (Did you HEAR OhElizabeth's story!) just fine around here from what I've seen. I've not passed the 8.5 lb mark yet, but from the wonderful stories I've heard on this board, I don't fear a larger baby the way I might otherwise have. :001_smile:

 

Yep! My only C-section was when I was induced and the baby just wasn't ready. I have birthed an 11# 14 oz baby( at home no less lol) . You can do it!

[emeraldjoy]

 

I chose a very hands-off midwife this time around because I KNOW at 38 weeks (and likely at 40 weeks) I'd be begging a willing doc to induce. Cause that's how you feel at the end! But I don't even want the option available to me this time, I know in my head it's better for a good labor and healthy baby to wait it out.

 

 

This was wise. I tried and had to switch providers. I told him from the beginning that I was not going to be induced and I am frustrated he even brought it up....because I know how anxious I am AND the size issue. I may go back in archives and see if I can find some stories. Thanks for the info.

[emeraldjoy]

I was induced 4 times. It was kind of nice to be able to schedule when the baby came. For me it was the right thing to do. If you are "ripe" your doctor might just break your water and your body would do the rest.

 

Thanks so much for your story. I like having a broad perspective.

e

[emeraldjoy]

Yep! My only C-section was when I was induced and the baby just wasn't ready. I have birthed an 11# 14 oz baby( at home no less lol) . You can do it!

I'm sorry, do my eyes decieve me or did you really have an almost 12 pound baby?

Thanks for the encouragement though. If you can do 12, I suppose I can do 10......ha, ha.

e

[Jami]

This was wise. I tried and had to switch providers. I told him from the beginning that I was not going to be induced and I am frustrated he even brought it up....because I know how anxious I am AND the size issue. I may go back in archives and see if I can find some stories. Thanks for the info.

 

:grouphug: Try not to be anxious. Your body can do what it needs to do! Maybe start a thread asking for specific stories on 9+lb babies. (Positive stories only of course!) I'm due just after Christmas, my in-laws (whom I really love and enjoy) will be here for Christmas. My midwife has reminded me that I need to stay calm and happy because stress and anxiety can keep a baby from coming. So don't worry...be happy...etc. etc. :001_smile:

[Chocolate Lover]

The weight estimate is often wrong. Even ultrasound weight estimates can be very wrong. The normal developement of the end of pregnancy is one half a pound per week. This doctor doubled that in order to scare you into having an induction. That is unethical. I know you aren't asking, but I would consider another care provider. Full disclosure here, I was a homebirth midwife for ten years. I believe you deserve a provider who honors your requests, needs and desires for your birth. Off my soapbox now.

[abbeyej]

I absolutely wouldn't. Estimating weight at term is essentially impossible. Sometimes they're close. Very frequently they're *way* off.

 

Not to mention that *position* plays a far, far greater role in pain and ease of delivery than weight does. I would take a look at Spinning Babies and do exercises from there a few times a day between now and labor to try to encourage optimal positioning. But I absolutely wouldn't induce unless baby or I were in imminent danger. The *possibility* (and really, they have no idea -- even ultrasound at full term is wildly inaccurate for estimating weight) of a large baby wouldn't cause me to consider induction.

[chickenpatty]

My first five babies were 9-10+ pounds, so with this last one, we were worried about the size, too. Two of my big ones came out with broken clavicles, bruised faces & I ended up with a painfully separated pubic bone. That kind of gives you an idea on why we didn't want another huge baby.

 

With the last one, I wasn't dilated yet, but was "soft". I went in for an induction and they started on with a cervadil capsule. That was all I needed - no pitocin or anything else. Maybe you could ask about that?

 

However, the huge baby turned out to be a peanut for us - 7lbs 15 ounces!

 

Moral of the story: you just never know! :tongue_smilie: I hope all goes well for you. The last couple of weeks are so long & hard! :grouphug:

[KatieJ]

My DD had her 2nd baby 2 weeeks ago. her first DS was 9# 6 oz and her inlaws were telling her from the get go that she should be induced at 38 weeks with any subsequent deliveries as babies only get bigger..blah blah. Her DH's aunt is a midwife and everyone seems to think she has all the answers..so when this aunt says induce, they all were believing her.

 

DD was finally induced at 42 weeks due to water leaking and postive Strep B. Pitocin is nasty stuff. She hated it. Labor was still long and very unproductive for hours and hours but when he was finally born, he was bigger and the actual delivery was no problem.

 

They are still discussing whether he was actually 2 weeks overdue or just big. I think he is perfect and actually seems smaller than his older brother. His head is definately smaller. It's all pretty much a guessing game and bigger doesn't necessarily mean more difficult.

 

My DD midwife told her that recent studies say Mom's who going into labor naturally tend to do better overal and was opposed to even considering induction until she was 42 weeks.

 

Bottom line don't let them talk you into something you really don't want.

[Jami]

My first five babies were 9-10+ pounds, so with this last one, we were worried about the size, too. Two of my big ones came out with broken clavicles, bruised faces & I ended up with a painfully separated pubic bone. That kind of gives you an idea on why we didn't want another huge baby.

 

 

 

I'm curious. Were these hospital births? Were forceps used? Was the pushing phase rushed? My 2nd baby was a very hurried pushing phase and had some bruising on her face even though she was only 7' 12 oz. I can imagine trying to avoid a larger baby if the extra complications were totally due to their size!

[Carol in Cal.]

When she was born, she was only 7.5 lbs.

[melissel]

I'm in the "I wouldn't without a really good reason" too. I was scared into an induction with my first because of the big baby thing too. They were saying she was over 9 pounds, and I didn't know any better, so (long story short) I ended up agreeing to one. She was something like 7 1/2 pounds at almost 42 weeks gestation, and my induction was horrible. I narrowly escaped a C-section and ended up with a forceps delivery. I know lots of inductions go just fine, and odds are you'd all be fine if you decided to go for it. But I agree with the others that weight estimations are notoriously inaccurate, and I wouldn't want another induction unless it was really necessary. My second, natural birth was a breeze (well, relatively speaking :D), and my recovery was so much easier that my DH told me he no longer believed me about how much I suffered recovering after my first :lol:

 

ETA: I forgot to say, though, that only you can make this decision based on your own experiences and concerns, so if you decide to go for the induction, your reasons are completely valid. I think we're all just saying, don't let them talk you into something your gut is saying no to. IMO, your baby, your decision, either way.

Edited November 12, 2008 by melissel

[Jennifer in MI]

No, I absolutely would not. Everyone else has mentioned how inaccurate weight measurements are, but even if your doc is right - at 38 weeks you have an 8 pound babe. They tend to gain 1/2 pound/week. That puts you at a 9 pounder in two weeks. It sounds to me like he's trying to scare you into an induction for his scheduling purposes.

 

Please do read about different positions that help open up the pelvis. I, too, had a 10 pound 2 ounce baby who got stuck. I was scared to death at the birth of my next child. But, I chose to deliver in the "hands and knees" position which is optimal for a child with a shoulder dystocia. She practically FELL out!!! But, I spent that entire labor scared to death about her actual birth. It wasn't a pleasant way to labor. (I did it to myself. I had wonderful midwives who KNEW I could do it!) It's unfair of your doc to scare you like that.

 

((((hugs))))) I pray everything goes exactly the way you want it to!

[chickenpatty]

I'm curious. Were these hospital births? Were forceps used? Was the pushing phase rushed? My 2nd baby was a very hurried pushing phase and had some bruising on her face even though she was only 7' 12 oz. I can imagine trying to avoid a larger baby if the extra complications were totally due to their size!

 

Yes, these were hospital births. Hmmm (trying to remember)... I don't feel like the pushing phase was rushed. We waited for contractions. The 10+ pounder took a long time to descend, I do remember that. Maybe that is one of the reasons for the broken clavicle (sp?) and the bruising. I can hardly bare to look at his newborn pics - his face was so purple, and he had an ace bandage wrapped around his shoulder to immobilize his arm... So pitiful! He was also turned the wrong way (posterior?) & it was pretty rough.

[LisaKinVA]

Honestly, I would avoid a hospital induction whenever possible. After your body has "been there, done that" -- you may just need more of a gentle nudge than anything.

 

My 2nd child, I'd been having regular (but non-productive) contrax. for hours -- I was already 5cm dialated and 100% effaced. About 9pm, we made the decision to break my water. 2 hours later, our daughter was born.

 

My 3rd child, repeat of #3... but was making very slow progress. I wasn't in any pain, but once they broke my water it was 2 hours later (HOWEVER, I only had three hard, painful contrax. before crowning and birth -- good thing dh was there, or I'd have been on my own!)

 

My 4th child... I was already 4cm dialated and 75% effaced. I was 39 weeks, had been having issues with constipation, so I took a full dose of milk of magnesia before bed, to clear up that issue. About 6:30pm the next day, I thought my water broke. I had my first twinge about 1.5 hours later, and Lizzie arrived just after 9pm that night.

 

As far as weight of babies is concerned... I was told my first one would be "lucky" to be over 6 pounds (especially, because I hadn't gained more than 17 pounds). He was 8lbs, 2 oz., My 2nd was nearly 9pounds (again, they thought she'd be smaller), my 3rd was "running large" and wound up being just 7 1/2 pounds (ha!), my 4th was "running small" and was just over 9lbs.

 

Like others have said, if your body and baby is ready, you may only need a nudge not a full-blown shove.

[Halftime Hope]

the possibility of doing perineal stretching exercises, also perineal massage. This is a two-person 'job' with your dh or birth partner, very non-sexual. ;)

 

If you are afraid of not being able to birth a big baby, there are a couple of considerations: position, as many have mentioned, and perineal stretching to teach the annular muscles at the vag. opening to relax and stretch out to accomodate the size of the soon-coming babe.

 

Hot compresses on the same area during the last stages of labor can also be very helpful in helping relax and loosen up/stretch that area. Do you have a MW or a doula to help?

 

HTH!

[PinkInTheBlue]

My 3rd was a scheduled induction and went extremely successfully. My body and I were truly ready and I was around 39 weeks. It was the right decision for us. In contrast to many others, I do NOT believe going overdue by much is a good idea at all. Many people say trust your body but mine just doesn't go into labor on its own. The further overdue someone runs, often the higher the complications of meconium can run.

[emeraldjoy]

Wow! Went to piano lessons and came home to a few pages of very wonderful, thought provoking, and appropriate stories for my situation.

Thank you so much.

I love hearing about other experiences, even though anecdotal, they make things just seem a bit more real.....

Again, thank you!!!

 

emerald

[PameliaSue]

My neighbor and very close friend has a similar story. Her FIRST dc was 10+ lbs and his clavicle was broken during labor. With her #2 dc the OB was freaking out telling her how big this baby was too. She responded to that fear and allowed them to induce her at 39 weeks. First they broke her water, then she had to have PIT and finally it all ended in a C-Section with a 6lb baby!!!! She was not even close to 39 weeks they decided once the baby was out.

She has since had 2 more dc vaginally. Each pregnancy she has dealt with the same fear no matter what doctor... she has had 3 OBs in all now. Each time they have told her that the babies were HUGE. Her #3 was close to the same size as #1 but a few ounces smaller and her #4 was only 9lbs 2oz.

Bottom line: it is very difficult to be accurate even with the newest most advanced technology available... which she had with #3 & #4. When she finally went into labor on her own she pushed those babies out on her hands and knees #3 and squatting #4.... My sister who is a licensed midwife was her doula:001_smile:. I do know that is was helpful for her to keep the fear at bay by surrounding herself with positive stories and lots of PRAYER.

[Raders Fan]

Well, in the interest of being "fair and balanced," I'd just like to say that I was induced 3 days to 3.5 weeks early with 5 of my 6. I had epidurals and pitocin and everything went well for the most part.

 

Good luck with your decision.

 

Jennifer

[PameliaSue]

I forgot to add that she consistently measures 2 to 3 weeks further along than she actually is. She starts measuring 40 weeks at like 37 and then the doctors start freaking. It took her until #3 to figure this out with the help of my sister. She just carries her babies high and that coupled with the near impossibility to accurately guess size near term.... plus she does have larger babies. With each baby she has had to FIGHT not to be induced because all the OB's thought that she was going over due... even WITH the documented medical records showing she always measures big. Her last OB listened to her more closely on the measuring thing but still ended up freaking out in the end and the baby was ONLY 9lbs 2oz.

 

Only a small percentage of us have TEXT BOOK cycles and bodies.

[joannqn]

I would never be induced unless there was a medical reason to do so.

 

I was induced with my last child but only because I was 2 weeks late and failed the nonstress test. Even then, we tried to start labor naturally for a free standing birth center birth first. It was only when that didn't work that I agreed to an induced hospital birth.

 

I worry about...

...the weight estimate being inaccurate

...the lungs being immature

...the heart not being fully developed

...the pitocin causing fetal distress and ER c-section

...the increased risks of infection & death that comes with preventable c-sections

 

I wouldn't do it. Deal with complications IF they happen rather than assuming they will happen.

[ma23peas]

My due date with my first was May 7..he came with FULL induction on May 26th!! I guess I'm one of the lucky whose gestational period runs 43 weeks! He was almost 9 pounds but they induced because he had no more fluid in the womb...or was dangerously low...my other two were also induced (my body will do braxton hicks for weeks but would never actually jump into full labor....my last was born at 9 lb. 8 oz...and all three of mine came out with just one push (granted 18-36 hours of hard pitocin kicked up to the highest level and anything will want to shoot out of there) but the size with my pelvic makeup didn't hurt my kids at all...I was told my body was made for birthing babies...hmm...don't know if that's a complement.

 

But, if the baby still has fluid in there and is not suffering (heart rate etc.) then I would wait it out...eat some Chinese and get lovey with your dovey...it might jsut start something! :)

 

Tara

[Kris]

I haven't read all the replies, but I wouldn't do it. I think the babies and the bodies know more about what's going on in there than the doctor does.

 

I know it's "fashionable" now to schedule these things so they're more convenient for the doctors, and when I first learned about that I thought it took some of the fun out of it! The mad dash to the hospital at 3:00 a.m. -- I always thought that was just part of the equation. Since then, I've also wondered how much "convenience" ends up costing the Moms and the babies.

[dirty ethel rackham]

the possibility of doing perineal stretching exercises, also perineal massage. This is a two-person 'job' with your dh or birth partner, very non-sexual. ;)

 

If you are afraid of not being able to birth a big baby, there are a couple of considerations: position, as many have mentioned, and perineal stretching to teach the annular muscles at the vag. opening to relax and stretch out to accomodate the size of the soon-coming babe.

 

Hot compresses on the same area during the last stages of labor can also be very helpful in helping relax and loosen up/stretch that area. Do you have a MW or a doula to help?

 

HTH!

 

There is some research out there to suggest that perineal stretching can do more harm than good because it can cause tissue breakdown. Many midwives have a mantra of "don't fiddle with the fanny":).

 

Lots of pelvic rocks, several times a day can help the baby get into a good position before labor.

 

During labor, positioning is very important. If mom is free to move around out of bed, she will instinctively choose positions that are positive for maneuvering the baby out. The worst thing a mom with a history of stuck babies can do is labor or push laying down in bed (or even partially sitting up in bed. Vertical and forward leaning positions are better for this type of situation because there is no pressure on the pelvis, so it is free to move to accomodate the baby.

[dirty ethel rackham]

Actually, Jessica, the risk of problems at 42 weeks are the same as the risks at 37 weeks, but many docs push to deliver a 37 week-er, but have a heart attack if someone goes to 42 weeks. The problems might be a little different, but the overall risk is about the same.

Edited November 12, 2008 by dirty ethel rackham
clarification

[Jennifer in MI]

Actually, Jessica, the risk of problems at 42 weeks are the same as the risks at 37 weeks, but many docs push to deliver a 37 week-er, but have a heart attack if someone goes to 42 weeks. The problems might be a little different, but the overall risk is about the same.

 

Yep. My earliest baby (38 weeks), non-induced had the heaviest meconium staining.

[Halftime Hope]

There is some research out there to suggest that perineal stretching can do more harm than good because it can cause tissue breakdown. Many midwives have a mantra of "don't fiddle with the fanny":).

 

OK. My last baby was nearly 14 years ago, so current thinking has undoubtedly changed. Thanks for the correction; if the research is sound, then it bears following. :001_smile:

[yslek]

With the last one, I wasn't dilated yet, but was "soft". I went in for an induction and they started on with a cervadil capsule. That was all I needed - no pitocin or anything else. Maybe you could ask about that?

 

 

If you do decide on the induction (which I wouldn't ;)) I would recommend you avoid Cervadil at all costs. It has its own uterine rupture (& maternal mortality) rate, and is not officially approved for induction (although it's used for inductions all the time-hence the uterine rupture rate.) I read about this in Ina May's Guide to Childbirth.

 

May you have a good delivery whatever you decide. :001_smile:

[WTMindy]

Personally, I loved being induced. I was induced both times (my dd was 10 days overdue and just not planning on ever coming out!!). Because she was so big (10-1), they induced me on my due date with my ds. I loved being able to plan the times and I had very easy deliveries.

[kat19]

I was induced twice.

One was with my first(13 years ago) and I hated it~seemed to take forever.

I was induced in March and although it went slow because they didn't break my water~it was much shorter then the first one. I got induced about 6:45, doctor didn't break my water until after 5:00(because he worked in the clinic all day) and I didn't give birth until 11:20pm. This was my only birth where I had an epidural.

I had to be induced both times due to preeclampsia.

 

It's your decision to make, if you feel you are ready, go for it. If you want to wait and let things happen on their own, go for it.

Sorry I'm not much help.

[kewb]

I was induced with my dd. I had rapid labor with my first and I lived potentially hours away from the hospital depending on what time of day I went into labor. It was a very positive experience for me. I was able to pick the day, my MIL was able to arrange ahead of time to watch ds, and everything went smoothly. But, that was me.

[KJB]

The little cutie in my avatar is my fifth baby just born at the end of July. My fourth baby was 9 lbs 5 oz and the weight of each of my children had been greater than the last until she was born. (She was 8 lbs 10 oz, btw, and they overestimated her weight based on ultrasound to be just over 10 lbs!!)

 

So...my recent OB, a german doc who is the Chief of OB where I delivered, told me that recent studies show that babies DO NOT gain weight after the 40th week of pregnancy. In other words, people having babies induced so the baby won't be too big when they are overdue are worrying needlessly.

 

According to him, your baby isn't going to get any bigger after that last week so if you can hang in there, you might as well!

 

Also, I've found labor better when I've let Mother Nature decide when my baby is to appear. Inductions can be rough and unnecessary intervention is usually best avoided, imho.

 

Either way, best of luck!! Your sweetie will be here soon!

Edited November 13, 2008 by KJB

[stripe]

It struck me reading your post that you're sort of being scared into an induction based on a speculation that the baby will be big which reminds you of the problems with a previous baby. I would explore better birth positions and resist efforts to induce.

 

Good luck in any event.

[NancyNellen]

Well, my perspective is different, I guess. Five babies. Induced five times. First and 4th w/ high blood pressure (both 39.5 weeks), 2nd and 3rd at 39 weeks when water broke and many hours passed w/ no contractions. My fourth baby, however, was 10 1/2 pounds (they estimated him at 9lbs.) and had shoulder dystocia. He was whisked away to NICU right after delivery and was very bruised (thankfully no broken collar bone!) It was very frightening! With #5 I opted to be induced at 38 weeks. He was 8 lbs. when he was born, so he probably would have been quite a bit bigger at 40 weeks.

 

I would do it again without question. It allowed me to be relaxed, knowing that I was not going to have another excruciating and scary delivery.

 

However he/she comes, congratulations!!

[The Governess]

I'll give you my experience. I wanted a natural birth. My doctor tried to pressure me into an induction before he left on vacation. I politely turned him down. I had an ultrasound at 41 weeks showing that she was 9.5 pounds. He scheduled an induction for 42 weeks because the max he would let me go overdue was 2 weeks. My daughter was born the night before my scheduled induction. She was 9 pounds 1 oz and I had no problems pushing.

 

My sister-in-law just had a home birth. Because of a thyroid issue, the OB she was seeing wanted to induce her. She had an ultrasound at 38 weeks that showed the baby was 8 pounds at that time. He used this to try to talk her into an induction when she was 39 weeks. She said no because she really wanted a home birth. My niece was born at 41.5, at home, and only weighed 7 pounds 4 ounces. Obviously, the ultrasound was way off!!

 

I pray that whatever happens, you have a wonderful birth! :grouphug:

[Susan in TN]

As others have said, weight guessing is very "unscientific", even when using an ultrasound. And it seems a bit "enthusiastic" to say the baby would gain a pound a week.

 

My first was a week late, 8 1/2 lbs and had a broken clavical. Sounds scary, but was really not a big deal. It's based more on the bone structure of the baby than purely on weight and the hospital drs. didn't even catch it until we went for a follow-up appt. a couple days later with our regular pediatrician. My 4th baby was heavier (9lb) but smaller structured - no clavical issues or bruising.

 

On the other hand, I have been induced twice and it wasn't the end of the world. It sounds like your body is gearing up to go soon, at any rate. If I were you, I'd just take it one week at a time - see how you feel about it in a few days.